Web Application Improves Survival and Follow-up for Patients With Lung Cancer

Using a web-based application to guide follow-up for patients with advanced lung cancer after they have received initial therapy may improve survival, according to a study presented at the 2016 American Society of Clinical Oncology Annual Meeting (June 3-7; Chicago, IL).

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Researchers developed the application to assist with the early detection of symptomatic relapse or complications and to provide more timely supportive care to patients with lung cancer. To test its effectiveness, they performed a national, multi-institutional study where they randomly assigned patients with lung cancer to receive either standard follow-up (physician visits and computed tomography scans every 3-6 months) or Web-application follow-up in addition to routine follow-up visits with physicians.

The Web application was used by patients to self-report the severity of their symptoms, which were then analyzed by the application and reported to the patient’s oncologist via email. Clinicians then determined changes to cancer care, including the initiation of supportive care. 

The study enrolled a total of 133 patients with stage III or IV lung cancer who had completed initial chemotherapy, radiotherapy, or surgery. The primary endpoint was to detect a 12% improvement in 9-month survival in the Web-application arm of the study.

At one year, 75% of patients in the Web-application arm were still alive compared with 49% of those in the standard follow-up group. In addition, overall survival was significantly improved in those who used the Web application (19 months vs 12 months, respectively).

Further analysis also showed that the Web application was associated with a 50% reduction in computed-tomography imaging per patient per year along with a higher overall quality of life.

Researchers concluded that, in addition to a significant survival improvement, using Web-application-guided follow-up for lung cancer led to earlier supportive care and a reduction in routine imaging.

"Through personalized follow-up using this convenient and simple online application, we can detect complications and signs of relapse and offer appropriate care earlier," said lead investigator Fabrice Denis, MD, PhD, Institut Inter-regional de Cancérologie Jean Bernard (Le Mans, France). "This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits to their oncologist."